YUMA RIFLE & PISTOL CLUB, LLC
Membership Application
Affiliated with the *NRA, *CMP, & *ASR&PA
Yuma, Arizona
For club membership, please complete this application and send it with your annual membership dues of $20.00. *Junior shooters pay $10.00. Fee is payable to the Yuma Rifle & Pistol Club, LLC. Print this page and send it to:
Joe Murek
17715 S. Avenue B,
SOMERTON, AZ 85350
____ New Member ____ Renewal ____ Junior Shooter
Members will have their annual membership beginning on the date the dues are received until the next anniversary date of the following year. Junior shooters (girls as well as boys) can be from 14 years old to their 20th birthday, inclusive.
NAME (First)________________(MI)____ (Last)________________________
ADDRESS_________________________________________
CITY_________________STATE ________ ZIP __________
PHONE # _______________ EMAIL ____________________
DATE OF BIRTH _______________ NRA # _______________
SIGNATURE ___________________________DATE ____________
For any additional information contact Joe Murek at: 928-627-4556/246-8952 or Jerry Brooker at: 928-305-9681
Please go to "Waiver" page on menu above. The waiver needs to be read, initialed, signed, and witnessed. It can be brought to any of our matches or practices, where it can be witnessed and filed. This application can be brought to any practice or match as well.
